Objective To summarize the experiences of surgical treatment for partial atrioventricular canal defect. Methods The data of 66 patients of surgical treatment for partial atrioventricular canal defect from January 1984 to December 2007 were analyzed retrospectively. The cleft of mitral valve presented in all of those patients. There were 52 cases with direct suture on cleft, 8 cases with direct suture with commissurroplasty, 1 case with posterior leaflet plasty, 3 cases with direct suture St.Jude ring and 2 cases mitral valve replacement. The ostium primum atrial septal defects were repaired with patches of Dacron in 12 cases and autologous pericardium in 54 cases. Coronary sinus was situated on the left atrium in 5 and ostium primum atrial septal defects were repaired in Kirklin’s way; the others in MeGoon’way. Meanwhile other heart abnormalities were done. Results There were two early deaths (3.03%), one patient died of heart arrhythmia and one patient died of respiratory failure. Complications of total A-V block was in 2 cases. Both of them were replanted with pace makers.52 cases were followed up, followup time was 5 months to 22 years(mean follow-up 15 years). All patients had better life. Four patients have been re -operated for different reasons post primary operation. One had good result after re-mitral valve replacement. One case died of acute renal failure and the other two died of low cardiac output syndrome. Conclusions Early operation is definitely recommended when the diagnosis is confirmed. Because the structure or function of mitral valve is saved, pulmonary hypertension is avoided and the mortality is lower in the future. The key points of operation are to rectify the mitral insufficiency, repair ostium primum atrial septal defects and avoid atrioventricular block. The patients of mild regurgitation of mitral valve have good results. Provided in those have more than middle regurgitation of mitral valve then their longterm results are poor.
Objective To study the effect of bone marrow mesenchymal stem cells(MSCs) implantation into infarcted myocardium on cytokine secretion and angiogenesis. Methods 24 Guizhou xiang porcine were equally divided into experimental group and control group randomly. Three ml bone marrow was extracted from the posterior superior iliac spine. MSCs were cultured according to the methods of Wakitani’s. After being co-cultured with 5-azacytidine for 24 hours, these cells were labeled with bromodeoxyuridine(BrdU). Autologus MSCs were implanted into the acute myocardial infarct site both via the distal segment of the ligated left anterior descending artery (LAD) and topical injection. 3 amp; 6 weeks after transplantation, the samples from experimental group and control group were collected to detect the expression of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and Ⅷ factor by immunohistology and video image digital analysis system. Results The expression of VEGF, bFGF and the microvessel counts in the experimental group were much higher than those of control group (Plt;0.01) at 3 and 6 weeks after transplantation. Conclusion MSCs, after being implanted into infarcted myocardium, shows the ability of secreting VEGF, bFGF, with subsequent angiogenesis.